MEDICARE: LINDA M BAYERKOHLER O.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	397	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7266753	OTHER	NV	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689620437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA M BAYERKOHLER O.D

Provider Business Mailing Address
First Line	:	7361 W LAKE MEAD BLVD
Second Line	:	STE 104
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1040
Country	:	US
Telephone Number	:	702-804-6133
Fax Number	:	702-804-6162

Provider Business Practice Location Address
First Line	:	7361 W LAKE MEAD BLVD
Second Line	:	STE 104
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1040
Country	:	US
Telephone Number	:	702-804-6133
Fax Number	:	702-804-6162

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	01/26/2011

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